Individual
INDIANA ELIZABETH RODAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2594 FERN VALLEY RD, CHULA VISTA, CA 91915-1560
(619) 459-2080
Mailing address
2594 FERN VALLEY RD, CHULA VISTA, CA 91915-1560
(619) 459-2080
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A6761074
DRIVER LICENSE
CA
Enumeration date
04/15/2025
Last updated
04/15/2025
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